Trend of mortality from ischemic heart disease and influenza vaccination in older adults in São Paulo

Bacurau, Aldiane Gomes de Macedo; Ferraz, Rosemeire de Olanda; Donalisio, Maria Rita; Francisco, Priscila Maria Stolses Bergamo

doi:10.1590/1413-81232018248.25472017

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Sumário

FREE THEMES • Ciênc. saúde coletiva 24 (8) • Aug 2019 • https://doi.org/10.1590/1413-81232018248.25472017 linkcopy

Trend of mortality from ischemic heart disease and influenza vaccination in older adults in São Paulo

Tendência da mortalidade por doenças isquêmicas do coração e a vacinação contra influenza em idosos em São Paulo

Authorship SCIMAGO INSTITUTIONS RANKINGS

The aim of the present study was to analyze the mortality trend due to ischemic heart disease (IHD) among older adults, identify changes in the trend and determine the correlation with influenza vaccine coverage (2000 to 2012) in the state of São Paulo between 1980 and 2012. An ecological time series study was conducted involving secondary data from Brazilian information systems. Linear and polynomial regression models as well as joinpoint regression were used to estimate the trends. Pearson’s correlation coefficient was used to evaluate the correlation between age-standardized mortality coefficients and vaccine coverage. A decreasing tendency in mortality due to IHD occurred in both sexes, higher mortality rates were found for males and greater reductions were found in the period after the vaccination campaigns. However, no statistically significant changes occurred in the year coinciding with or near the onset of the campaigns. In the overall sample, no evidence of a linear correlation was found between the mortality coefficients and vaccination coverage. Other factors directly associated with morbidity and mortality due to ischemic heart disease may have influenced the trend.

Key words
Mortality; Health of the elderly; Cardiovascular diseases; Myocardial ischemia; Influenza vaccines

Year	Male		Female		Male/Female Ratio
Year	Number of Deaths	Stand. Coef.	Number of Deaths	Stand. Coef.	Male/Female Ratio
1980	7199	110.84	6239	91.27	1.21
1981	7207	106.00	6334	87.38	1.21
1982	7222	101.99	6269	81.39	1.25
1983	7675	103.24	6748	83.41	1.24
1984	7927	102.19	6760	79.63	1.28
1985	7902	97.60	6899	77.56	1.26
1986	7743	91.81	6840	73.09	1.26
1987	8039	91.40	7170	73.32	1.25
1988	8572	94.00	7366	72.28	1.30
1989	8431	89.43	7419	69.77	1.28
1990	8557	87.76	7597	69.49	1.26
1991	8340	82.35	7519	65.07	1.27
1992	8440	79.98	7365	60.78	1.32
1993	8733	83.53	7591	64.32	1.30
1994	8805	82.96	7772	64.79	1.28
1995	8640	81.69	7714	63.33	1.29
1996	9468	79.83	8154	58.52	1.36
1997	9334	77.51	8384	59.26	1.31
1998	9065	74.57	8166	56.85	1.31
1999	9561	77.62	8433	58.26	1.33
2000	9644	68.07	8611	49.21	1.38
2001	9470	65.93	8639	48.82	1.35
2002	9591	66.12	8676	48.46	1.36
2003	10,055	68.49	8723	48.15	1.42
2004	10,281	69.18	8998	49.14	1.41
2005	9680	63.43	8381	44.61	1.42
2006	9996	64.79	8662	45.59	1.42
2007	9951	52.69	8722	36.39	1.45
2008	10,280	53.54	8844	36.16	1.48
2009	10,439	52.30	8908	34.95	1.50
2010	10,790	52.29	9348	34.52	1.51
2011	11,087	53.33	9609	35.23	1.51
2012	11,168	53.34	9607	34.98	1.53
Model	Y = 78.18 - 1.77(year - 1996)		Y = 59.27 - 1.71(year - 1996)		Y = 1.34 + 0.009 (year - 1996)
Trend	Decreasing (p < 0.001; R² = 0.97)		Decreasing (p < 0.001; R² = 0.98)		Increasing (p < 0.001; R² = 0.90)

Sex	߮β ₀	߮β ₁	p-value	R²
Male 60 to 69 70 to 79 ≥ 80 years Total	46.12 94.59 195.78 78.18	-0.84 -2.15 -5.46 -1.77	<0.001 <0.001 <0.001 <0.001	0.96 0.96 0.95 0.97
Before* After**	91.34 62.38	- 1.86 -1.79	<0.001 <0.001	0.94 0.84
Female 60 to 69 70 to 79 ≥ 80 years Total	22.67 62.48 175.40 59.27	-0.48 -1.85 -5.50 -1.71	<0.001 <0.001 <0.001 <0.001	0.95 0.97 0.98
Before* After**	71.93 44.09	-1.78 -1.73	<0.001 <0.001	0.94 0.90
Total 60 to 69 70 to 79 ≥ 80 years Total	33.54 76.49 183.14 67.71	-0.66 -2.01 -5.51 -1.76	<0.001 <0.001 <0.001 <0.001	0.96 0.97 0.97 0.98
Before* After**	80.73 52.09	-1.85 -1.77	<0.001 <0.001	0.95 0.87

Sex	Age Group	Period	APC	95% CI	AAPC	95% CI
Male	60 to 69	1980-1996 1996-2012	-1.2* -2.5*	-1.6 to -0.9 -2.8 to -2.1	-1.9*	-2.1 to -1.6
	70 to 79	1980-2004 2004-2012	-2.0* -3.7*	-2.3 to -1.8 -4.8 to -2.6	-2.5*	-2.8 to -2.1
	≥ 80 years	1980-2005 2005-2008 2008-2012	-2.6* -8.7 2.9	-2.8 to -2.3 -19.2 to 3.1 -0.7 to 6.7	-2.5*	-3.6 to -1.3
	Total	1980-2005 2005-2008 2008-2012	-2.0* -6.9 0.5	-2.2 to -1.8 -16.2 to 3.3 -2.3 to 3.4	-2.2*	-3.2 to -1.2
Female	60 to 69	1980-1986 1986-1997 1997-2005 2005-2009 2009-2012	-3.3* -0.8* -3.0* -5.8* 1.6	-4.5 to -1.9 -1.4 to -0.2 -4.0 to -2.0 -9.6 to -1.8 -2.6 to 5.9	-2.2*	-2.9 to -1.5
	70 to 79	1980-2003 2003-2012	-2.7* -4.2*	-3.0 to -2.5 -5.2 to -3.2	-3.1*	-3.5 to -2.8
	≥ 80 years	1980-2005 2005-2008 2008-2012	-2.8* -9.9 0.5	-3.1 to -2.6 -25.4 to 8.9 -4.2 to 5.4	-3.1*	-4.8 to -1.3
	Total	1980-2005 2005-2008 2008-2012	-2.6* -8.8 -0.2	-2.7 to -2.4 -19.2 to 3.0 -3.4 to 3.0	-2.9*	-4.0 to -1.7
Total		1980-2005 2005-2008 2008-2012	-2.3* -7.8 0.1	-2.5 to -2.1 -17.4 to 2.9 -2.7 to 3.1	-2.5*	-3.6 to -1.5

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[TFN1] Note:

[TFN2] ^*
Standardization using direct method (standard population: the population of the state of São Paulo from the 2010 Census).

[3] Source: Mortality Information System of the Ministry of Health (SIM/DATASUS)